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UPDATE: I’ve added a second, longer letter from Dr. Daskalakis, posted on X/Twitter.

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Moments ago, Inside Medicine broke news that three top career CDC officials have resigned from the agency, hours after the Washington Post reported that newly-confirmed Director Dr. Susan Monarez has been ousted, having run afoul of Health Secretary Robert F. Kennedy Jr.

Here are the emails that each of the officials sent to their CDC colleagues by Dr. Deb Houry, Dr. Demetre Daskalakis, and Dr. Daniel Jernigan.

Dr. Deb Houry, Deputy Director for Program and Science/Chief Medical Officer:

“Over the past decade, I have had the honor of working for six CDC directors, from both Republican and Democratic administrations. To me, these leaders and my colleagues were not “Red” or “Blue,” but red, white, and blue—united in the shared purpose of protecting health and saving lives in our beloved country and globally. I have served during this time in various leadership roles, including as CDC’s senior-most career leader and lead for the transition as the current administration assumed office.

I’ve always been proud to be part of an institution that is committed to using science and data to drive our life-saving work and inform our messaging. We have worked tirelessly to enhance openness through public-facing data dashboards, providing real-time access to trends for conditions such as mpox, H5N1, measles, and overdose deaths, allowing the public to make informed decisions. Additionally, I have witnessed the rapid translation of science into action, with some Morbidity and Mortality Weekly Reports (MMWRs) being published within a week of an outbreak.

For the good of the nation and the world, the science at CDC should never be censored or subject to political pauses or interpretations. Vaccines save lives—this is an indisputable, well-established, scientific fact. Informed consent and shared decision-making must focus not only on the risks but also on the true, life-saving benefits that vaccines provide to individuals and communities. It is, of course, important to question, analyze, and review research and surveillance, but this must be done by experts with the right skills and experience, without bias, and considering the full weight of scientific evidence. Recently, the overstating of risks and the rise of misinformation have cost lives, as demonstrated by the highest number of U.S. measles cases in 30 years and the violent attack on our agency.

CDC must continue its work on all diseases, including noncommunicable health conditions, which include many of the leading causes of death in the US. I have seen the value of integrating these efforts with those of other CDC programs, as we did with the Zika virus. Integrating expertise from across the agency is critical to our effectiveness in addressing novel and emerging diseases. CDC has proven its value in addressing conditions like hypertension, diabetes, cancer, overdose, and mental health issues, as evidenced by the progress in reducing overdose deaths this year. However, proposed budget cuts and reorganization plans will negatively impact CDC’s ability to address these conditions, worsening the nation’s health.

I love this agency. Nevertheless, I have submitted my resignation today. I am committed to protecting the public’s health, but the ongoing changes prevent me from continuing in my job as a leader of the agency. This is a heartbreaking decision that I make with a heavy heart.

To the CDC staff, you are the reason I stayed and showed up each day during difficult times. I have done my best to provide support so that you can continue your critical work. Thank you for your continued commitment to our mission and the work you do every day.

As I move on to the next phase of my career, I will continue to advocate for the values that have always driven my work—science, data, and evidence-based solutions to public health challenges. I have been privileged to contribute to the CDC’s mission in many roles, including as Chief Medical Officer, and I am deeply grateful to have had the opportunity to serve alongside you.

Deb Houry, MD, MPH.”

Dr. Demetre Daskalakis, Director of the National Center for Immunization and Respiratory Diseases (two emails, one to colleagues, and a longer formal resignation):

“It has been a great pleasure to serve in the role of Director of NCIRD. I wish I could say more in person, but wanted to make sure that you all have heard from me directly that I have submitted my resignation. I am not able to serve in this role any longer because of the ongoing weaponizing of public health. You are the best team I have ever worked with, and you continue to shine despite this dark cloud over the agency and our profession.

Please take care of yourself and your teams and make the right decisions for yourselves. I will send a longer email to our Center this evening or in the morning.

Demetre Daskalakis.”

And here is Dr. Daskalakis’s formal resignation letter to Dr. Houry, posted on X/Twitter:

“Dear Dr. Houry, I am writing to formally resign from my position as Director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention (CDC), effective August 28, 2025, close of business. I am happy to stay on for two weeks to provide transition, if requested. This decision has not come easily, as I deeply value the work that the CDC does in safeguarding public health and am proud of my contributions to that critical mission. However, after much contemplation and reflection on recent developments and perspectives brought to light by Secretary Robert F. Kennedy Jr., I find that the views he and his staff have shared challenge my ability to continue in my current role at the agency and in the service of the health of the American people. Enough is enough. While I hold immense respect for the institution and my colleagues, I believe that it is imperative to align my professional responsibilities to my system of ethics and my understanding of the science of infectious disease, immunology, and my promise to serve the American people. This step is necessary to ensure that I can contribute effectively in a capacity that allows me to remain true to my principles. I am unable to serve in an environment that treats CDC as a tool to generate policies and materials that do not reflect scientific reality and are designed to hurt rather than to improve the public’s health. The recent change in the adult and children’s immunization schedule threaten the lives of the youngest Americans and pregnant people. The data analyses that supported this decision have never been shared with CDC despite my respectful requests to HHS and other leadership. This lack of meaningful engagement was further compounded by a “frequently asked questions” document written to support the Secretary’s directive that was circulated by HHS without input from CDC subject matter experts and that cited studies that did not support the conclusions that were attributed to these authors. Having worked in local and national public health for years, I have never experienced such radical non-transparency, nor have I seen such unskilled manipulation of data to achieve a political end rather than the good of the American people. It is untenable to serve in an organization that is not afforded the opportunity to discuss decisions of scientific and public health importance released under the moniker of CDC. The lack of communication by HHS and other CDC political leadership that culminates in social media posts announcing major policy changes without prior notice demonstrate a disregard of normal communication channels and common sense. Having to retrofit analyses and policy actions to match inadequately thought-out announcements in poorly scripted videos or page long X posts should not be how organizations responsible for the health of people should function. Some examples include the announcement of the change in the COVID-19 recommendations for children and pregnant people, the firing of scientists from ACIP by X post and an op-ed rather than direct communication with these valuable experts, the announcement of new ACIP members by X before onboarding and vetting have completed, and the release of term of reference for an ACIP workgroup that ignored all feedback from career staff at CDC. The recent term of reference for the COVID vaccine work group created by this ACIP puts people of dubious intent and more dubious scientific rigor in charge of recommending vaccine policy to a director hamstrung and sidelined by an authoritarian leader. Their desire to please a political base will result in death and disability of vulnerable children and adults. Their base should be the people they serve not a political voting bloc. I have always been first to challenge scientific and public health dogma in my career and was excited by the opportunity to do so again. I was optimistic that there would be an opportunity to brief the Secretary about key topics such as measles, avian influenza, and the highly coordinated approach to the respiratory virus season. Such briefings would allow exchange of ideas and a shared path to support the vision of “Making America Healthy Again.” We are seven months into the new administration, and no CDC subject matter expert from my Center has ever briefed the Secretary. I am not sure who the Secretary is listening to, but it is quite certainly not to us. Unvetted and conflicted outside organizations seem to be the sources HHS use over the gold standard science of CDC and other reputable sources. At a hearing, Secretary Kennedy said that Americans should not take medical advice from him. To the contrary, an appropriately briefed and inquisitive Secretary should be a source of health information for the people he serves. As it stands now, I must agree with him, that he should not be considered a source of accurate information. The intentional eroding of trust in low-risk vaccines favoring natural infection and unproven remedies will bring us to a pre-vaccine era where only the strong will survive and many if not all will suffer. I believe in nutrition and exercise. I believe in making our food supply healthier, and I also believe in using vaccines to prevent death and disability. Eugenics plays prominently in the rhetoric being generated and is derivative of a legacy that good medicine and science should continue to shun. The recent shooting at CDC is not why I am resigning. My grandfather, who I am named after, stood up to fascist forces in Greece and lost his life doing so. I am resigning to make him and his legacy proud. I am resigning because of the cowardice of a leader that cannot admit that HIS and his minions’ words over decades created an environment where violence like this can occur. I reject his and his colleagues’ thoughts and prayers, and advise they direct those to people that they have not actively harmed. For decades, I have been a trusted voice for the LGBTQ community when it comes to critical health topics. I must also cite the recklessness of the administration in their efforts to erase transgender populations, cease critical domestic and international HIV programming, and terminate key research to support equity as part of my decision. Public health is not merely about the health of the individual, but it is about the health of the community, the nation, the world. The nation’s health security is at risk and is in the hands of people focusing on ideological self-interest. I want to express my heartfelt gratitude for the opportunities for growth, learning, and collaboration that I have been afforded during my time at the CDC. It has been a privilege to work alongside such dedicated professionals who are committed to improving the health and well-being of communities across the nation even when under attack from within both physically and psychologically. Thank you once again for the support and guidance I have received from you and previous CDC leadership throughout my tenure. I wish the CDC continued success in its vital mission and that HHS reverse its dangerous course to dismantle public health as a practice and as an institution. If they continue the current path, they risk our personal well-being and the security of the United States.

Sincerely, Demetre C. Daskalakis MD MPH (he/his/him)”

Dr. Daniel Jernigan, National Center for Emerging and Zoonotic Infectious Diseases:

Colleagues: I wanted to let you know directly that I have submitted my resignation as Director of the National Center for Emerging and Zoonotic Infectious Diseases effective tomorrow. This was a very difficult decision for me. I have had the incredible opportunity to serve the American people doing meaningful and impactful work for over 30 years.

Since 1994, I have worked at CDC with some of the most intelligent, driven, and compassionate people, working to detect, control, and prevent infectious diseases. These efforts have had significant impact mitigating illness, preventing deaths, and improving the lives of millions of people.

I believe strongly in the mission of public health and the leadership that CDC has given for almost 80 years; however, given the current context in the Department, I feel it is best for me to offer my resignation.

I am so grateful for being able to work with all of you and know that you will continue doing the highest level of science and public health.

Thanks

Dan.”

The news of these resignations set off a firestorm in public health circles. This is not normal. There had been speculation that this particular trio of leaders would resign depending on how the September meeting of Secretary Kennedy’s newly-installed CDC Advisory Commitee on Immunization Practices went. There has been mounting fear that Secretary Kennedy will attempt to link vaccines to autism in a forthcoming HHS report, and that ACIP will be expected to remove many of its recommendations, some decades old, that have protected American children from death and severe illness from preventable diseases. But news of Monarez’s ouster meant that the writing was on the wall, moving these resignations up by weeks.

Frankly, the very future of the CDC is unknown. Thousands of good scientists and other agency officials remain. But without these key leaders—non-partisan career officials widely respected both internally and beyond—the agency is genuinely at risk of losing its ability to carry out its core mission. That’s not because any three people, (regardless of how experienced or respected they may be) are irreplaceable, but, rather, for what their departures portend. Other leaders and career scientists may also soon exit or be forced out. At some point, core mission activities that keep us safe will be at risk of being unfulfilled.

When these losses will translate to decreased safety to Americans that is noticeable is an open question. But, we’re about to find out…

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That’s all for now. Thanks for reading and supporting science, facts, and the actual American way!

If you have information about any of the unfolding stories we are following, please email me or find me on Signal at InsideMedicine.88.

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